The clinical teacher最新文献

Background: Obtaining sufficient written feedback from faculty members on clerkship student evaluations is challenging. Few successful interventions, however, have been published on improving written feedback or evaluation content.

Methods: We evaluated and scored medicine clerkship student evaluation forms from one academic year (2011/12) for timeliness, grade distribution and the number of written comments. Based on this assessment, faculty members received a feedback report documenting their performance at the end of the year to encourage improvement. Medicine clerkship student evaluation forms were scored again for the same criteria the following academic year (2012/13) to ascertain the impact of the feedback reports on evaluation timeliness, grade distribution and the number of written comments.

Results: Sixty-one faculty members completed student clerkship evaluations in both years, and received feedback reports. There was no change in the overall timeliness, grade distribution or number of written comments. There were 13 faculty members (21%) identified as 'low performing', who were responsible for 75 per cent (21/28) of the evaluation forms without any written comments. Within this subgroup, the proportion of evaluation forms with comprehensive comments (mostly sentences) increased after implementing the feedback reports [3/42 (7%) versus 9/25 (36%), p = 0.006]. Obtaining sufficient written feedback from faculty members on clerkship student evaluations is challenging

Discussion: At our institution, the majority of inadequately completed clerkship evaluation forms are generated by a small group of low-performing faculty members. Providing feedback to these faculty members about their student evaluations was associated with improved performance the next year. Targeted feedback to low-performing faculty members may be an effective strategy to improve student evaluations.

Background: The Prevocational General Practice Placement programme (PGPPP) aims to provide junior doctors with professional, well-supervised, educational rotations in general practice. There is a paucity of literature evaluating the educational effectiveness of the PGPPP. This study aims to compare general practice rotations with hospital rotations, with respect to teaching and support, acquisition of skills and knowledge, and role autonomy.

Methods: All junior doctors who participated in a PGPPP rotation were invited to complete a voluntary anonymous online survey using the Postgraduate Hospital Educational Environment Measure (PHEEM) inventory. The PHEEM presents Likert scales grouped into four subscales for participants to rate statements about their rotations. Surveys were completed at the end of the year in which doctors undertook a PGPPP rotation, and covered all rotations. These survey findings were used to compare general practice and hospital rotations.

Results: In all four subscales of teaching, clinical skills, social support and role autonomy, the general practice rotation performed as well as, or better than, hospital rotations in the areas of emergency, medicine, and surgery. General practice outperformed all other rotations in 15 out of 20 statements across all subscales.

Discussion: This study demonstrates the educational value of a general practice placement in comparison with hospital placements. Expansion of the PGPPP should be considered to provide all junior doctors with the benefits of exposure to generalist skills in the community.

Background: Residency programmes struggle with the systems-based practice and improvement competency promoted by the Accreditation Council for Graduate Medical Education. The development of Innovative Health Systems Projects (IHelP) was driven by the need for better systems-based initiatives at an institutional level. Our objective was to develop a novel approach that successfully incorporates systems-based practice in our Graduate Medical Education (GME) programmes, while tracking our impact on health care delivery as an academic medical centre.

Methods: We started the IHelP programme as a 'volunteer initiative' in 2010. A detailed description of the definition, development and implementation of the IHelP programme, along with our experience of the first year, is described. Residents, fellows and faculty mentors all played an important role in establishing the foundation of this initiative. Following the positive response, we have now incorporated IHelP into all curricula as a graduating requirement. IHelP has promoted scholarly activity and faculty mentorship, [and] has improved aspects of patient care and safety

Results: A total of 123 residents and fellows, representing 26 specialties, participated. We reviewed 145 projects that addressed topics ranging from administrative and departmental improvements to clinical care algorithms. The projects by area of focus were: patient care - clinical care, 38 per cent; patient care - quality, 27 per cent; resident education, 21 per cent; and a cumulative 16 per cent among pharmacy, department activities, patient education, medical records and clinical facility.

Discussion: We are pleased with the results of our first year of incorporating a systems-based improvement programme into the GME programmes. This initiative has promoted scholarly activity and faculty mentorship, has improved aspects of patient care and safety, and has led to the development of many practical innovations.

Background: Medical student involvement in curriculum development is important; however, little is known about why medical students become engaged in this activity. The aim of this study was to understand what motivates medical students at one university to participate in the process of curriculum development and gain a wider perspective on student engagement in medical education.

Methods: Grounded theory methodology was the foundation of this study. We conducted semi-structured interviews with seven medical students from the University of Tokyo who developed and participated in a group whose aim was to actively contribute towards improving their medical education. The data from the interviews were analysed by thematic synthesis, with triangulation.

Results: Three themes emerged as potential explanations for motivating student behaviour: (1) extracurricular interaction with faculty members; (2) engaging with highly motivated peers; and (3) student values for serving the public.

Conclusions: Students working to improve educational processes at their medical schools had the opportunity to communicate more with faculty members, enjoyed opportunities for networking with other highly motivated peers and enhanced aspects of their developing professionalism.

Background: Negative attitudes adversely impact on patient care and outcomes. Given the aging population in Australia, it is inevitable that paramedic attendance to this demographic of patients will also rise. It is therefore imperative that undergraduate paramedic attitudes towards elderly patients are investigated, along with pedagogical approaches to maintain or enhance them.

Methods: Eleven second-year paramedic students enrolled in Monash University's Bachelor of Emergency Health (Paramedic) degree, came together with 11 independently living elderly residents from Patterson Lakes Village and participated in an engagement activity. The Aging Semantic Differential (ASD) survey and focus groups were used to analyse the students' attitudes towards the elderly, before and after the activity.

Results: Students showed improved attitudes toward the elderly across two of the three ASD dimensions. Focus group discussions suggested that students found the elderly participants to be more independent and capable than they had first thought, but were unchanged on their attitude with regard to elderly people being inflexible.

Conclusion: Students were presented with an opportunity to actively engage with independently living elderly patients. This experience challenged their preconceived ideas about the elderly and their capabilities, and at a minimum increased awareness, which will assist future paramedics in their interactions and care of these patients.

Background: Most academic hospitalists fulfil the role of clinician educator and have many opportunities for the bedside clinical teaching of resident physicians; however, hospitalists are promoted at lower rates than traditional internal medicine faculty staff. The conflict between the demands of clinical productivity and time to teach may be central to understanding the lower rates of academic promotion seen in hospitalists. This investigation explores the relationship between clinical productivity and learner evaluations of hospitalist clinician educators.

Methods: A retrospective review of clinical productivity and learner evaluations of hospitalists by residents was collected during the 2009-2012 academic years at Southern Illinois University School of Medicine. Correlation analysis between annual work relative value units (wRVUs), patient encounters and duty days with resident evaluations of faculty staff in the Accreditation Council for Graduate Medical Education core competencies was performed.

Results: Forty-one annual data sets, representing 18 individual hospitalists, were analysed. No significant correlations between clinical productivity, in terms of annual work RVUs, patient encounters and duty days, and resident learner evaluation scores was found. This investigation explores the relationship between clinical productivity and learner evaluations of hospitalist clinician educators

Discussion: This study found no significant influence of measures of annual clinical service workload on resident learner evaluations of hospitalist clinical educators. These results are consistent with data reported for emergency medicine doctors and anaesthesiologists. These results may have significant implications for the staffing requirements for academic hospitalists.

Background: Effective learning from simulation-based training depends on expert facilitation by skilled faculty members, but there are few guidelines upon which to base simulation development. A collaborative approach was taken in the East of England to determine the agreed content of such a course.

Methods: A modified Delphi method was used to determine consensus amongst the simulation-provider leads in the East of England on what should be the essential elements of a training course for faculty members. A questionnaire designed by a steering group was circulated to the consensus group, and their responses were used to modify subsequent questionnaires. There was enough agreement after two rounds not to require a third round.

Results: After two rounds there was high level of agreement that the educational content should include scenario design, creating a supportive learning environment, structured debriefing formats, human factors, educational feedback and communication. There was also agreement on preferred teaching methods, minimum qualification and continuing development for faculty members. There was moderate agreement on the prior experience required of faculty members, and no agreement on the costs of courses. Effective learning from simulation-based training depends upon expert facilitation by skilled faculty members

Discussion: By using a consensus method to determine the content and format of a simulation development course designed for faculty members, there is agreement in the East of England on what constitutes an educationally sound programme. This should provide assurance to both simulation providers and commissioners of education that despite the absence of guidelines, there is an agreed practice standard for simulation-based training in the region.